When Lower Extremity Dysfunction Contributes To Back Pain

Author(s): 
George C. Trachtenberg, DPM

In conclusion, I think podiatric practitioners should be looking closely at patients with complaints of low back pain and carefully assess their walking mechanics. It is imperative to assess movement difficulties and dysfunctions in the sagittal plane when evaluating and treating these particular patients. The results of eliminating podiatric biomechanical dysfunctions through appropriate orthotic treatment, particularly when addressing abnormal conditions in the sagittal plane, can yield remarkable results for the patient with low back dysfunction.

   Dr. Trachtenberg is in private practice in Vestal, N.Y. He specializes in video and computerized gait analysis to evaluate the postural effects of abnormal walking that can lead to disorders affecting the knees, hips, back and other related musculoskeletal dysfunctions. Dr. Trachtenberg is a Fellow of the American College of Foot and Ankle Surgeons, and a Diplomate of the American Board of Podiatric Surgery.

References

1. Dananberg HJ. The Effect of Gait on Chronic Musculoskeletal pain. Manual for The Langer Foundation for Biomechanics and Sports Medicine Research, 1992 pp.16-22.
2. Seminars with Howard Dananberg, DPM.
3. Dananberg HJ, Guiliano M. Chronic low back pain and its response to custom foot orthoses. J Am Podiatr Med Assoc. 1999;89(3):109-17.
4. Dananberg HJ. Gait style and its relevance in the management of chronic lower back pain. In: Vleeming A, Mooney V, Gracovetsky S, Lee D, et al. (eds): Proceedings, 4th Interdisciplinary World Congress of Low Back & Pelvic Pain, Montreal, Canada, November 8-10, 2001, pp. 225-230.
5. Dananberg HJ, Guiliano M. Gait mechanics and their relationship to lower back pain. In: Vleeming A, Mooney V, Tilscher H, Dorman T, Snijders C. (eds): Proceeding of 3rd Interdisciplinary World Congress on Low Back and Pelvic Pain. European Conference Organizers, Rotterdam, Holland, November 1998.
6. Dananberg HJ. Gait style and function of the SIJ. In: Vleeming A., Mooney V, Snijders C, Dorman T (eds): Movement, Stability, and Lower Back Pain. Churchill Livingstone, New York, 1998, pp. 253-267.
7. Dananberg HJ. Lower extremity pathomechanics and its effect on sacroiliac function. In: Dorman T (ed): Spine—State of the Art Reviews, Prolotherapy. Hanley & Belfus, Philadelphia, 1995, pp.389-405.
8. Dananberg HJ. Gait style as an etiology to chronic postural pain. Part II. The postural compensatory process. J Am Podiatr Med Assoc. 1993;83(11):615-24.
9. Dananberg HJ. Gait style as an etiology to chronic postural pain. Part I. Functional hallux limitus. J Am Podiatr Med Assoc. 1993;83(8):433-41.
10. Lawton M, Dananberg, HJ. Functional hallux limitus and chronic musculoskeletal pain. Abstract. J Phys Med Rehab. November 1991.
11. Murphy N. Pressure profiles and force assessments to treat biomechanical foot and gait related disorders. Congress Proceedings 2010 World Congress of Podiatry, Amsterdam, Netherlands, May 13-15, 2010.
12. Murphy N. Murphy 4P method for F-Scan® systems. Manuscript. Tekscan, Inc., Boston, 2006, pp. 22.
13. Murphy N. General foot function & gait analysis using the Murphy 4P method with F-Scan®. Clinical case study manuscript. Tekscan, Inc., Boston, 2005, pp.1.
14. Murphy N. Improving asymmetry during gait using the force-time graph in F-Scan®. Clinical case study manuscript. Tekscan, Inc., Boston, pp.1.
15. Trachtenberg G. Great gait. How mapping technology can analyze gait & provide data to help restore normalcy. Advance Phys Ther Rehab Med. 2010;21(20):23.
16. Trachtenberg G. Enhanced foot function and gait analysis using the 3Box approach with F-Scan®. Educational monograph. Tekscan, Inc., Boston, 2005.
17. Trachtenberg G. Using video to complement F-Scan® data. Educational monograph. Tekscan, Inc., Boston, 2005.
18. Trachtenberg G. Using F-Scan® to evaluate orthotic prescriptions, orthoses and orthotic labs. Educational monograph. Tekscan, Inc., Boston, 2005.
19. Trachtenberg G. Using F-Scan® with or without “test orthoses” for orthotic prescription writing. Educational monograph. Tekscan, Inc., Boston, 2005.

Comments

Very informative and important paper.

I would just like to add that flexion of the spine can also be a result of the pelvis rotating posteriorly, which is called a posterior innominate. Comparing the PSIS to the ground in neutral calcaneal stance position to relaxed calcaneal stance position will help in ascertaining how orthoses will help in unilateral cases.

I am presently doing a study on the relationship of the lateral talus subluxation to the posterior innominate.

Eventually, we should become part of the team to treat the back.

Are there any recommendations for soft vs hard heel lifts in back pain?

Add new comment